Ending Teen Substance Abuse: The Stages of Change

Although the process of ending an addiction, or making any type of major change, can feel chaotic, there is a roadmap for transformation. In 1983, clinician James Prochaska and others developed a model that outlined six stages of change. It is known in the mental health field as the Trans-Theoretical Model (TTM) and casually as the Stages of Change. The model incorporated a variety of clinical theories (thus, the name Trans-theoretical) as well as the observations of individuals attempting to create sustainable behavior change.

The TTM Model, the Stages of Change, is often used to facilitate freeing adolescents (and adults) from addiction or other unhealthy habits, such as quitting smoking. The stages and their explanations are listed below. They can be used as a map if you or someone you care for is attempting to make such a transformation.

Pre-contemplation: At this stage, a teen may not recognize there is a problem. There are no thoughts about making any change at all. If anyone points out a concern, an adolescent in this stage would feel that that he or she is exaggerating. The impact of the problem has not become conscious and there is no consideration to make any adjustment to one’s life.

Contemplation: Teens in this stage are willing to consider that there might be a concern. However, there ambivalence is high. They haven’t made a firm decision to change; rather, they know that the drinking or drug use is problematic and are willing to look at pros and cons to sobriety. At this stage, a counselor or therapist might make accompany an adolescent through a risk-reward analysis. Together, they might examine previous attempts to change in the past, causes for failure, and benefits and barriers to change.

Determination: The hallmark of this stage is that a decision to change has been made. Although there continues to be some ambivalence, the determination to change is strong enough to outweigh any obstacles. There is a serious attempt to change with a realistic look at anticipatory problems, concrete solutions, and a sensible plan for recovery.

Action: As the energy of determination continues to build, an adolescent takes action and chooses to implement his or her recovery plan. A teen might make their commitment to change public by telling friends in order receive external validation for their efforts. This stage might also include attending support groups, AA meetings, or individual therapy. As a recovery plan succeeds, emotional rewards might also become evident such as self-confidence, happiness, and optimism.

Maintenance: Although a recovery plan is in place and a teen has taken action towards that plan, maintaining sobriety can be challenging. This stage might even include relapse, but the foundation for a sober life is becoming firm. An adolescent is becoming more aware of old habits and is growing the ability to make healthier choices. The test of this stage is maintaining the new behavior in order to create a life-long change.

Termination: Some clinicians do not include this stage in the TTM model, particularly when applied to substance abuse. Some clinicians believe that once there is an addiction, there will always be one and that the stage of maintenance is ongoing. However, other clinicians see this stage a time when the individual is no longer tempted or threatened by any substances. He or she has complete confidence in his or her sobriety.

It should be noted that these stages of change could be applied to anything. However, they have successfully been used for over 30 years with substance abuse users and healing from addictions. Whether you are someone you care for is searching for sobriety or freedom from other unhealthy behaviors, the stages above present a roadmap for change.

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